Depression and anxiety associated with chronic diseases can be difficult to cope with, especially in chronic kidney disease. A recent publication in BMC Nephrology indicated that CKD patients on dialysis have significantly worse health related quality of life (HRQL), as determined through a survey of 98 CKD patients. It is important for healthcare providers to recognize this impact of CKD and be alert for poor HRQL in the patients under their care.
“Clinicians should be aware of the effects of long-term denial and could examine the possibility of screening for defensive coping and depression in recently diagnosed CKD patients with the aim to improve both physical and mental health,” stated Dr. Anna Kaltsouda, lead author on the study, “Defensive Coping and Health-Related Quality of Life in Chronic Kidney Disease: A Cross-Sectional Study.”
The study was designed to better understand how HRQL is affected specifically in CKD, as it is known that defensive coping is increased in individuals with chronic diseases. As an added factor, the researchers joining Dr. Kaltsouda at the University of Ioannina in Greece wanted to determine how the different CKD stages can further influence HRQL. To achieve these goals, the research team administered a 36-item Short-Form health survey (SF-36) to 79 pre-dialysis and 19 dialysis patients (stages 3 to 4) in the nephrology department of their university. Defensive coping was further determined by the Rationality/Emotional Defensiveness (R/ED) scale of the Lifestyle Defense Mechanism Inventory (LDMI).
During the SF-36, patients answered questions related to how their state of health affects their daily activities. The R/ED tested how patients’ emotions are affected by their disease. The two tests were highly related in terms of mental health. When patients exhibited higher defensive coping, they had a lower score for the mental component of the SF-36. To a lesser degree, these same patients exhibited a positive increase in the physical component of the SF-36. “The results provided evidence that emotional defensiveness as a coping style tends to differentially affect the mental and the physical component of HRQL in CKD,” concluded the authors.
Overall, patients on dialysis had worse HRQL as determined through the SF-36. Clinicians are advised to pay special attention to their dialysis patients to determine if these are having trouble coping with CKD to an extent that it affects HRQL. If a clinician identifies poor coping in a patient, the two can work together to help improve overall HRQL.